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Conflict of Interest in Medical Research, Education, and Practice
to the activities of medical product companies. Because these programs are aimed at physicians outside academic institutions, this research is reviewed in Chapter 6.
THE LEARNING ENVIRONMENT IN ACCREDITEDCONTINUING MEDICAL EDUCATION
Physicians commit to life-long learning to keep pace with new knowledge and skills and to maintain their current skills. Most state licensing boards, specialty boards, and hospitals require accredited continuing medical education for relicensure, recertification, or staff privileges. Thus, it is important to promote a constructive learning environment in this arena as well as in undergraduate and graduate education. This discussion focuses on accredited continuing medical education. (As noted earlier, this report uses the phrase accredited continuing medical education to refer to education that is presented by accredited providers and is certified for course credits.)
Providers of accredited continuing medical education are more numerous and diverse than providers of undergraduate and graduate medical education. The major ACCME-accredited providers are physician membership organizations (n = 270), publishing/education companies (n = 150), medical schools (n = 123), and hospitals and health care delivery systems (n = 93). In 2008, ACCME had 740 accredited providers of continuing medical education, and state medical societies accredited approximately 1,600 additional providers (ACCME, 2008a, 2009). What ACCME calls “publishing/education companies” are often described as “medical education and communication companies,” or MECCs, and that term is used here. According to data reported by the Society for Academic Continuing Medical Education (SACME) for 2006, about 40 percent of medical schools held commercially sponsored “satellite” meetings in conjunction with national professional society meetings, and 70 percent of these meetings were managed by communications companies (SACME, 2007).
Table 5-2 shows the shares of total income, participants, hours of instruction, and activities (all providers) accounted for by several types of accredited continuing medical education providers. Medical schools accounted for a considerably larger share of total hours of instruction than might be expected from their share of the total income received by education providers. In contrast, MECCs (publishing/education companies) account for a considerably smaller share of all instructional hours than of total income.
Accredited continuing medical education programs embedded in medical schools are shaped in part by the missions, culture, and challenges of the larger institution. The programs’ members are represented by SACME,